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Thermometers #72975
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Hi all,

A question on how you all manage testing thermometers. Do you test them annually? If you haven't seen a particular unit for a number of years, how long do you leave it before classifying it as "Lost/Missing"

Problem I see is they keep getting "lost/stolen" so replacing one for either of the previous reasons increases the database size thus increasing the number of lost/missing assets over the period of time then making the PPM figures look worse than they typically should be.

Interested in how you all manage them with regards to PPM figures and with your active database.


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Re: Thermometers [Re: Adaml] #72978
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Kevin Finn Offline
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Personally I would remove all thermometers from the database, its an unmanageable item. Best advice I would give is buy the £20 to £30 infra red ones and just give them to nurses, if they get broken, lost or stolen then don't worry about it. Same can be said with nebulisers, just stop trying to manage them, it really is a waste of time and resources.

Kevin - Born in the USA!

Re: Thermometers [Re: Adaml] #72979
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Hi Kevin

Thank you for the reply. Do you work within a NHS Trust? if so were they content with that? I agree it is a unmanageable item. The majority get pinched!


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Re: Thermometers [Re: Kevin Finn] #72981
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DaveC in Oz Offline
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Can't agree with you there Kevin. However annoying small things like thermometers may be, they are still a diagnostic device and as such need to be tested unless you are prepared to do a risk assessment and remove them that way. Standards do not allow for devices to be ignored just for our convenience.
That being said, they do go awol regularly and we give then 24 months before a list is sent to the NUM of the ward asking them to either produce the device (this applies across all device types) or sign the form saying it can't be found and then we decommission from our database. By doing this we not only involve the staff in looking for missing devices but also keep our "missed items" list somewhat under control.

Dave


Thoughts and information provided on this forum are mine and mine alone and do not necessarily reflect the policy of NSW Health. They may also be complete bollocks!!
Re: Thermometers [Re: Adaml] #72982
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As I may have mentioned a few times before ... don't waste time trying to hunt down kit like this.

But rather, put the monkey on the back of the user (account holder, inventory holder, head of department, budget holder, equipment co-ordinator - or whomever else is responsible, "owns", or is otherwise accountable for the kit concerned).

As PM becomes due simply send the user a list of kit (per inventory) that is due for inspection, requesting them to make it available for PM.

In well managed organisations, equipment gets signed for, generally cared for, and is well looked after; and if - or when - it goes missing, the account holder is held to account. For high-ticket items (and it's up to Senior Management to decide where the limit lies), an enquiry is made; such an enquiry leads to consequences - punitive, fiscal or criminal. The same goes for wanton damage, by the way.

Similarly, when kit is loaned out to patients, the patient (or someone acting for the patient) signs for it and a record is kept by the person issuing (handing over) the item. If the kit is never seen again (ie, stolen), the record is recovered and the patient gets the bill!*

For small items such as those being discussed, the account holder needs to replace any missing items from his or her budget.

This stuff is not Rocket Science (although I suspect it does not sit welll with the modern "no blame" culture). frown

Regarding maintaining the integrity of the database - something along the lines of what Dave is saying is the way forward (that is, logical). smile

* Or, better still, a visit from the Old Bill (not that that's ever likely to happen in the UK).

Re: Thermometers [Re: Adaml] #72988
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richard coleman Offline
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Hi Adam

we have the same problem with lost stolen thermometers so we decided not to give the units an asset number but we do put a next test due label on. it is then up to the user to report to us when they need checking( once a year).

Re: Thermometers [Re: Adaml] #72989
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Hello, I do work for the NHS and in previous places we have introduced this via the Medical Devices Group or whatever its called, it proved to be very successful basically we stopped doing thermometers, stopped testing class 2 devices for EST and stopped trying to manage nebulisers.

It proved to be very successful and there was no issue in the clinical areas. I have to disagree with Dave in Oz as I don't see thermometers as a high risk diagnostic device, I am even at the point of not testing nerve simulators and basically anything that causes lots of running about to try and find the item. We are also looking at not doing ECG stand alone machines on PPM and making them repair only, basically when called out to look at the device we do a full check anyway less EST so what's the point of a PPM? Carry out a repair PPM only and everyone's a winner.

When companies are giving you 5 year warranty's with devices and no maintenance at all i.e. Some Ultrasound devices and CPAP machines, I think its time we really asked ourselves is there any point in testing. I am currently doing a project on modules and monitors to see if we can make these repair only. Obviously if a module like some GE ones E-CAIOV (Gas) needs filters then this will still be done but E-PRESTN or E-PSMP modules, come on, lets get real and with the times .... are we really doing PPMs just for the sake of doing them?

Kevin Stuart Finn .........

Re: Thermometers [Re: Kevin Finn] #72990
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You raise a couple of interesting points there, Kevin ... that are worthy of a new thread, I would have thought.

So why not open a new thread, and let's have the debate! smile

Personally, for many years (as in, forty or so) I have been a great supporter of PM (and I mean, PM everything); later on (the last twenty years or so) I have moved on to advocate "risk-based PM" (aka the Risk-Based Model). However, my mind always remains open for reasoned argument.

As a historical note, when I started working in army hospitals in the early 1970's the basic equipment support policy was "repair as (when) necessary". There was also an annual inspection for functionality of all the kit by an outside inspector from "Head Quarters"; basically we (the resident techs) had to demonstrate that the kit worked. Then just about the time I started in earnest, we had to begin doing (what we referred to as) "quarterly inspections" (what we would later call PM). Later on (after the army), having numerous opportunities to set up equipment maintenance from First Principles (more or less), I tried various methods of supprting equipment; but always ran some sort of PM programme. Later still, after becoming aquainted with US methods of biomedical engineering, I learned about the Risk-Based approach to PM, and became a confirmed covert to this (to my mind) rational, sensible way of doing things. By the way, perhaps it's worth mentioning that I also attended to equipment repairs (as well as PM); but it should be said that I don't remember too many "surprises" (that is, thanks to our PM programmes, we knew our equipment domain almost as well as a shepherd knows his flock!

Re: Thermometers [Re: Adaml] #72991
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While I am not familiar with the standards used in the UK, the Australian standards are, I believe, quite similar (AS 3551:2012). 3551 mandates that all devices must be tested at a minimum of 12 monthly unless a risk assessment shows that less frequently is acceptable. Do the UK standards mirror this approach?

If so, Kevin, have you done a full risk assessment on the devices you are now excluding from annual testing and if you have I would love to have a look at them?

I would agree that a lot of the testing that we do is a complete waste of time and resource and I wish we did not have to do it but this is what the standards require and until the standards change or we can produce a risk assessment that is robust enough to stand up in a court of law we are stuck with it. To ignore the standards without this is to expose both yourself and your employer to a legal risk that, if revealed, could expose you to disciplinary action, dismissal for gross negligence, or land you in court.

And by the way, I did not say that a thermometer was a "high risk" device, clearly it is not, but it is a diagnostic device and therefore falls under the standards.

Dave


Thoughts and information provided on this forum are mine and mine alone and do not necessarily reflect the policy of NSW Health. They may also be complete bollocks!!
Re: Thermometers [Re: DaveC in Oz] #72992
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Yes Dave ... the tools are there (for those who care to use them).

As I may have mentioned many times before, "Risk" is the answer. That is, each equipment type needs to be assigned a *Risk value (or factor):- Low, Med, High (or some more elaborate regime).

I believe it is easier to include "everything" on the inventory (database, dependency, whatever) then allow for a system whereby PM intervals may be adjusted according to need. For example, a PM interval of 999 days more or less equates to a policy of "repair when broken", even though a PM programme remains in place.

More advanced applications of Risk-Based PM allow PM intervals to be adjusted (lengthened or reduced) as time passes (PM cycles pass) depending on the condition of the equipment during recent PM visits.

Also, I always advise that each item of equipment be allocated a statement (which can, or should, be just a simple code) about how it is to be maintained - a "Maintenance Support Policy", if you like. That way, everyone involved can be made aware about how the item is to be maintained; and yes, it could be "on contract" ... or even "discard when broken" if you prefer!

Again, as I have mentioned before (sorry folks), to my mind one of the essential elements of a PM programme is that the technician comes into contact with each item of equipment on a regular basis! smile

* Perceived risk to the patient in case of equipment failure.

Re: Thermometers [Re: Kevin Finn] #72993
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Originally Posted by Kevin Finn

When companies are giving you 5 year warranty's with devices and no maintenance at all ...


What control do these companies have over how these "devices" are used (and the environments they are used in); how often do they take a look at them?

Are we to understand that they totally disregard stuff like electrical safety, then? think

Sorry Kevin, to my mind that's a fail. frown

What's your ultimate "vision for biomed", Mate ... that the in-house guys simply slink away and surrender the field to occasional visits from "manufacturers" from who-knows-where ... or what?

What's the status of CPAP units run for five years without a filter change - or a wipe down with a disinfecting cloth? "Gopping", I should imagine.

Re: Thermometers [Re: Geoff Hannis] #72994
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What's the status of CPAP units run for five years without a filter change - or a wipe down with a disinfecting cloth? "Gopping", I should imagine.[/quote]

This is so true, but when you cant manage the device (even the clinical staff cant manage the swap out) then we should really start looking at these devices as disposable devices.

Re: Thermometers [Re: Kevin Finn] #72995
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If the management cannot manage the devices, then (by definition) management has failed. frown

It sounds to me like these hospitals you are talking about need to get a grip!

Meanwhile, here's an idea:- let the patients buy the kit they need; then they can do whatever they want with it. whistle

PS: at one place I worked a few years back patients used to come in every now and then for "follow up". They had to bring their CPAP etc. devices with them. One of us used to go along and attend the session to check out the devices - functional check, filter changes and so forth. Surely the clinical staff can manage something like that?

Re: Thermometers [Re: Adaml] #72996
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totally disagree about not servicing, what happens if a piece of kit causes harm or death to a patient?? the first thing asked for will be the service history as with CQC inspections. I understand that it is a pain finding equipment but if you do best effort then the onus is on the user that's why we have next test due labels.

Re: Thermometers [Re: richard coleman] #72997
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"Hand-holding" (of clinical staff by the biomeds) has been going on so long that it has become the norm (a de facto tradition).

Unless Senior Management dishes up more resources for in-house biomedical engineering teams commensurate with the ever-increasing workload (more equipment, more regulatory demands etc.) - which, I suppose, is unlikely in most cases - then something has to give.

So:- no more hand-holding; user staff must take responsibility for their inventories. frown

We look forward to the day when the only calls we get from user departments are along the lines of "When are you coming to service my kit? The stickers say you are due this week"! smile

And, I might add, "property management" (the tracking down of assets, and asset management in general) is the job of Property Control.

Re: Thermometers [Re: Geoff Hannis] #72998
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We already provide a service that will PPM a CPAP when the patient comes in for a clinical appointment ...... the problem is we have over 3000 CPAP machines.

Re: Thermometers [Re: Kevin Finn] #72999
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So you do PM CPAP units, then.

OK ... it sounds like you need more resources. smile

Best speak to Senior Management. Don't forget to mention the thermometers, nebulizer compressors et al.

Re: Thermometers [Re: Geoff Hannis] #73001
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We did, however CPAP now come with 5 years warranty and no service ....... 3000 CPAP assets and it grows every month :-)

Re: Thermometers [Re: Kevin Finn] #73002
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A PM programme for 3,000 simple pieces of kit sounds like a nice little contract opportunity to me. whistle

Re: Thermometers [Re: Adaml] #73019
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Kevin Finn Offline
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Nearly as good as the £250 a PPM per T34 I know someone is charging ................

Re: Thermometers [Re: Kevin Finn] #73021
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Nice one. smile

But is anyone actually paying that amount?

Where is the kit ... offshore Guinea-Bissau, or some such place?

Re: Thermometers [Re: Geoff Hannis] #73036
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If they are then they must have an M2 screw loose.

( I'll get my coat... )

Last edited by Lee Bradley; .
Re: Thermometers [Re: Adaml] #73055
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There defo paying it ............

Re: Thermometers [Re: Kevin Finn] #73544
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Originally Posted by Kevin Finn
Nearly as good as the £250 a PPM per T34 I know someone is charging ................


Good work if you can get it! I am in the wrong job smile


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